THEORETICAL FOUNDATION IN NURSING
Betty Neuman “System Model” (Health Care
System Model)
Nursing
 To prevent stress invasion, to protect the
client’s basic structure and to obtain or
maintain a maximum level of wellness.
Betty Neuman
1924
 Born near Lowell, Ohio
1947
 Received RN diploma from People’s Hospital
School of Nursing, Akron, Ohio.
 Hospital staff and head nurse; school nurse
and industrial nurse; and as a clinical
instructor in medical-surgical, critical care
and communicate disease nursing.
1957
 Attended University of California at Los
Angeles (UCLA) w/ double major in
psychology and public health.
 Received BS in Nursing from UCLA
1966
 Received Master’s Degree in Mental Health,
public Health Consultation from UCLA
 Recognized as pioneer in the field of nursing
involvement in community mental health.
 Began developing her model while lecturing
in community mental health at UCLA
1972
 Her model was first published as a “Model
for Teaching Total Person Approach to
Patient Problems” in Nursing Research
1985
 Received doctorate in Clinical
Psychology from Pacific Western
University
1998
 Received second honorary doctorate- this
one from Grand Valley State University,
Allendale, Michigan.
Goal of Model
 Provide a holistic overview of the
physiological, psychological, socio-
cultural, and developmental aspects of
human beings.
Overview of Neuman’s system Model
 The aim of the Neuman model “…is to set
forth a structure that depict the parts and
subparts and their interrelationships for
the whole of the client as a complete
system” (Neuman, 2002 p.11)
 The Neuman’s system model has two
major components --- STRESS and
REACTIONS TO STRESS.
 The client in the Neuman’s model is
viewed as an open system in which
repeated cycles of input, process, output
and feedback, constitute a dynamic
organizational pattern. The client may be
an individual, a group, a family, a
community, or an aggregate.
The Six Major Concepts Are:
1. client
2. variables
3. environment
4. stressors
5. wellness
6. Nursing intervention.
I. Person Variables
 Each layer of the concentric circle of the
Neuman’s System Model is made up of five
person variables, which are as follows:
1. Physiological Variable - Refers to the
“physiochemical structure and function of
the body”.
Ex. Individual system and Community
System
2. Psychological Variable - Refers to the
“mental processes and emotions.”
Ex. self-esteem and its effect on
relationships for the individual and
communication patterns for a family.
3. Developmental Variable - Refers to those
processes related to development over
the lifespan.
Ex. “empty nest syndrome” & “sandwich
generation”
4. Sociocultural Variable - Refers to the
relationships; and social and cultural
expectations and activities.
Ex. ethnic cultural practices and health
belief practices
 5. Spiritual Variable - Refers to the influence
of spiritual beliefs.
Ex. anointing the sick or dying with oil,
avoiding scavenger fishes
II. Central Core
 The basic structure or central core is made
up of the basic “survival factors”
 These factors include system variables,
genetic features, and the strengths and
weaknesses of the system parts.
 A person’s system is an open system and
therefore is dynamic and constantly
changing and evolving. Stability or
homeostasis occurs when the amount of
energy that is available exceed that being
used by the system. A homeostasis body
system is consistently in a dynamic process
of input, output, feedback, and
compensation which leads to a state of
balance.
III. Flexible Line of Defense
 Acts as cushion and is described as
accordion- like as it expands away from or
contracts closer to the normal line of
defense.
IV. Normal Line of Defense
 Represents system stability over time. It is
considered to be the usual level of stability
in the system.
V. Lines of Resistance
 Protect the basic structure and become
activated when environmental stressors
invade the normal line of defense.
VI. Reconstitution
 It is the increase in energy that occurs in
relation to the degree of reaction to the
stressor.
 Begins at any point following initiation of
treatment for invasion of stressors.